Lymph Node Metastasis and its Risk Factors for Early Gastritis Individuals Who Underwent Noncurative Endoscopic Resection: A Systematic Review and Meta-Analysis

Na Xu; Yuejun Zhang; Xiaoxia Ma; Wei Meng

doi:10.18502/ijph.v53i10.16697

Na Xu Department of Digestive Endoscopy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, No. 105, Jiefang Road, Jinan, 250013, China
Yuejun Zhang Department of Digestive Endoscopy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, No. 105, Jiefang Road, Jinan, 250013, China
Xiaoxia Ma Department of Digestive Endoscopy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, No. 105, Jiefang Road, Jinan, 250013, China
Wei Meng Department of Digestive Endoscopy Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, No. 105, Jiefang Road, Jinan, 250013, China

DOI: https://doi.org/10.18502/ijph.v53i10.16697

Keywords: Noncurative endoscopic resection; Early gastric cancer; Endoscopic dissection

Abstract

Background: In the present review, we carried out a systematic review and meta-analysis to analyze possible lymph node metastasis (LNM) hazards in individuals with endoscopic resection of gastric cancer.

Methods: Relevant literature was selected by evaluating the PubMed, Cochrane Library, and Google Scholar electronic databases since from inception to March 2022. Corresponding clinicopathological outcomes were summarized, and pooled log odds ratios and 95% confidence intervals were assessed. The random effect model was preferred if variations among studies is high otherwise fixed effect model was preferred.

Results: Overall, 12 associated papers, including 4808 early gastric cancer individuals who endured more surgery after noncurative endoscopic resection, were entered into this analysis. The outcomes showed that submucosal invasion (log odd ratio 1.75, 95% (CI): 0.77–3.95, I² = 80.0%); vertical margin (log odd ratio 6.53, 95% (CI): 2.81-15.17, I²= 65%); horizontal margin (log Odd ratio 0.69 95% (CI): 0.22-2.14, I² = 52%), lymphatic invasion (Odd ratio 6.33 95% (CI): 1.98-20.24, I² = 91%), and vascular invasion (Odd ratio 3.55, 95% (CI): 1.31-9.58, I²= 92%) was significantly related to metastasis of lymph node for these patients.

Conclusion: There was a significant association of LNM hazards in individuals with endoscopic resection of gastric cancer. Therefore, invasion to lymph, vascular, submucosa and positive vertical margin should be strongly noticed when selecting surgical treatment factors.